Spondylodiscitis – symptoms, causes and treatment

Inflammation of the vertebral bodies and intervertebral discs

The Spondylodiscitis refers to a usually bacterial inflammation caused to the intervertebral discs, the spread on the two surrounding vertebral bodies. Depending on the severity and localization of different symptoms, mostly accompanied by back pain. The diagnosis of this serious disease is often made relatively late, so that essential therapy measures, such as treatment with Antibiotics and possibly surgery, often at an advanced stage. In many cases, residual damage to the spine back to stay.

Table of contents

A brief Overview

Inflammation of the intervertebral disc and vertebral bodies is a serious disease that needs immediate treatment, to prevent possible consequential damage. Read the short summary of the main facts on the topic of Spondylodiscitis and to inform you in detail in the following article.

  • Definition: The Spondylodiscitis is an inflammation, the primary of the intervertebral disc and the two adjacent vertebral bodies is spreading. A Synonym is frequently used, the term Diszitis that describes an isolated inflammation of the intervertebral disc.
  • Symptoms: Depending on the localization and expression develop back pain or pain radiating to the spine, the fever and other signs of inflammation are accompanied can. Also, restrictions in movement, sensory disturbances and a certain degree of weakness (including muscle weakness) are one of the possible complaints.
  • Causes: In most cases, a staph infection responsible for the inflammation. But also other pathogens or autoimmune cause disease is a Spondylodiscitis.
  • Diagnosis: the diagnosis can be, must in the case of suspicion of detailed images of a magnetic resonance tomography can be evaluated. Additional blood tests and possibly a pathogen determination are part of the examination and during the treatment.
  • Treatment: In most cases, intensive antibiotic therapy is essential. In severe cases and complications of a surgical procedure for the removal of the infected structures is carried out in addition. A longer period of immobilization and gradual Regeneration and Stabilisation of the affected spinal segment is an important part of the therapy.
  • Naturopathic treatment: a Variety of complementary measures in the field of Natural medicine and alternative treatment methods may, in consultation with the school medical therapy, the healing process by activating the body’s own defenses to support.

Definition

In the case of Spondylodiscitis is an inflammation that affects primarily the intervertebral discs and spreads in the further course of the two adjacent vertebral bodies. The Spondylitis, is an infection emanating from the vertebral bodies and, secondarily, to the intervertebral discs is transferred (Osteomyelitis of the spine) and the Diszitis, a rarely occurring isolated intervertebral disc inflammation is to be distinguished. Spondylodiscitis but is often used as a synonym for Diszitis, since in the vast majority of cases, an inflammation of the intervertebral discs may spread to the vertebrae.

The disease belongs in the group of spinal and back disorders to the inflammatory Spondylopathien, which are not described in detail. Strictly speaking, the word Spondylus on the vertebrae and the word Discus (Discus intervertebralis) is related in the medical language on the disc. The suffix -itis indicates the inflammatory nature of a disease.

The disease can occur at any age, increasingly it comes from the fiftieth year to such a disease, and although more common in men than in women.

Symptoms

The complaints depend on the severity and localization of inflammation. The symptoms are often not very characteristic, but in most cases, it comes to back pain. The pain in the back, to the more local and all of a sudden (acute), often in a state of rest, or at night. Since it is inflammation that can occur under certain circumstances, a flu-like symptoms, with fever, chills, night sweats and General fatigue.

Also, it can lead to sensation disturbances, weakness (muscle weakness) and stiffness in the back. These symptoms occur in an otherwise rather in connection with nerve damage. Depending on the starting point of the back may radiate pain also, and similar to a herniated disc perceived. Also flank pain, or Ischia are often pain described. There is also a tension, such as neck tension, develop, and other muscular discomfort.

Causes

Usually the inflammation by the bacterium Staphylococcus aureus causing, the from another infected Region in the organism immigrates (endogenous infection). The infection can also arise in the context of an intervertebral disc surgery or in open injuries. Other bacteria and fungi (only very rarely parasites) have already been identified as a disease trigger. This inflammation is also called non-specific Spondylodiscitis.

With the rare specific Spondylodiscitis from infection of the bones and joints in the spine with the tuberculosis pathogen Mycobacterium tuberculosis , the speech (skeletal tuberculosis). This disease develops always on the endogenous route of infection.

A non-bacterial inflammation, diseases other reason, so-called autoimmune diseases, the cause for the pathogenesis of the disease. For example, Bechterew’s disease (ankylosing Spondylitis), a chronic inflammatory rheumatic car can lead to immune disease that mainly affects the Tendons and joints of the spine, also to inflammation of the intervertebral disc and vertebral body.

Also, it seems to be a General favourable factors for the emergence of a Spondylodiscitis. A excessive alcohol consumption, obesity, heart disease (cardiovascular disease) and Diabetes mellitus include, for example,.

Diagnosis

The distinction of the various disorders, and inflammation forms in the spine is not easy and usually requires extensive investigations. To should from the beginning be asked in the medical history, whether or not due to other diseases, immunosuppressive-acting drugs are taken. Because immunosuppressive drugs, or a generally poor General condition conducive to bacterial inflammatory processes.

In the clinical investigation will be analysed, as a rule, the exact origin and nature of the occurring pain and other possible ailments, such as movement restrictions, considered in more detail. To diseases exclude a similar symptoms (differential diagnostics) of the Further neurological studies.

In case of suspicion of Spondylodiscitis x-ray to be carried out diseases in any case, radiological investigations as with other spine (nuclear spin tomography (MRI) and computer tomography). Best on MRI images using contrast agents to the corresponding pathological detection of changes. Depending on the stage of the disease, a reduction in Height of the affected intervertebral discs can be visible (compression of the cartilage disks), and various bone damage, similar to a osteolysis. Sometimes, it is also possible to detect due to the infection, Abscesses (paravertebral or epidural Abscesses), or even an infestation of the spinal area.

Additional laboratory investigations a blood sample should in particular be in terms of various inflammatory parameters part of the diagnosis. Often a more germ-analysis by blood culture or biopsy is necessary to be able to have the appropriate Treatment setting.

Treatment

Inflammation in the area of the intervertebral disc and vertebral body are often detected late and treated. A diagnosed Spondylodiscitis should be taken from the Affected person and the treating of people but very serious and appropriate medical treatment should be initiated immediately. This is because the bacterial infection can spread if left untreated, even to other adjacent regions and leads quite often to follow heavy and lengthy complications to life-threatening conditions with.

In most cases, a conservative, medical therapy is essential, which consists of the intravenous administration of antibiotics. Usually an inpatient stay in hospital during this treatment. In the case of prolonged duration of therapy may later be, under certain circumstances, an oral intake changed, which can sometimes be also managed in an outpatient treatment.

Immobilization of the affected spinal area is also an integral part of a successful therapy. For torso orthoses can be applied and a strict bed rest for several weeks is necessary in many cases.

No bacterial infection, but an infection by fungi or other pathogens, must antifungal, an anti – (or an exception is also an anti-parasitic) therapy cases, be made. In the case of a proven specific infection, there is a need for a rapid anti-TB drugs therapy.

In severe risk cases (emergency), associated, for example, with neurological deficits or Sepsis, a surgical procedure may be necessary and sometimes the only chance of Survival. In the process, infected structures are removed, for example by means of a discectomy (removal of disc tissue) and subsequent blocking of the two surrounding vertebral bodies. A abscess drainage, and other invasive measures may be required. Usually a prolonged antibiotic therapy of such a surgery and also postoperative mobilization (movement therapy) is for the Regeneration of great importance.

Not infrequently, the rest remain after the antibiotics treatment as well as after surgical therapy of ailments that are attributable to a number of irreversible damage to the adjacent segments after ausgeheilter inflammation. Mostly Affected are suffering from neurological or motor deficits of varying proportions. In the further healing process but can still be achieved, improvements that increase the quality of life accordingly.

Naturopathic and complementary treatment

In the case of inflammation and bacterial infections there are many natural healing methods and natural remedies that relieve symptoms and help prevent further spread. In the case of a Spondylodiscitis, as well as in other severe inflammations, but it is first and foremost a school, medical treatment is advised.

To support antibiotic therapy or in the post-operative process can be used in medical and therapeutic advice is also a healing plant with anti-inflammatory and anti-bacterial effect (for example, Angelica, Arnica, devil’s claw, or horsetail).

For a better regeneration ability of the immune system after surgery, the complementary method of the mistletoe therapy is known. However, this method, as well as the hyperbaric oxygen therapy (HBO therapy) for the prevention of spread of Infection is still controversial.

The strengthening of the immune system that can come in addition, methods such as autologous blood therapy, and self-urine therapy, as well as the thymus therapy for the application. In this context, it is also used often back on various home remedies, homeopathic remedies or Schuessler salts. A healthy nutrient budget should be prepared in any case for optimal recovery. (tf, cs)